[b]Preventable Deaths: Is U.S. Domestic Security and Public Health Spending Out of Balance?[/b]
A look at how much the U.S. has spent through Homeland Security since 9/11 and what the government spends on preventing deaths through public health
By Katherine Harmon | September 8, 2011 | 3
The deadly plot unrealized. The heart attack not had. The truth is that the successes of both national security and public health often pass by unnoticed. Failures are tallied in fatalities. But assessing the social value of programs by counting the number of people who do not die, such as people saved by detecting a bomb or by new food labeling laws, can make effectiveness tough to measure.
The matter is further obscured by the nature of the threats they aim to fend off. Especially since the 9/11 attacks, security threats often loom larger in the collective national consciousness than health threats, although the chances of dying in a plane crash (of any kind), for instance, is about one in 20,000, whereas the odds of dying from a stroke are about one in 23—with the bulk of strokes likely being preventable. Disparate odds of this order are true of most security versus health risks.
So, how is the federal government spending money to stave off deaths from bombings and bugs alike? And does that spending reflect the relative risks of health threats versus security threats? Here is a glance at the budgets of the U.S. Department of Homeland Security (DHS), which is charged with terrorism prevention, cyber security and immigration enforcement, among other things, and the U.S. Centers for Disease Control and Prevention (CDC), which helps to fight infectious and chronic diseases, prevent injury and improve other health areas.
For the 2012 fiscal year, the DHS requested $57 billion in funding from the federal government, promising to have cut more than $800 million from administrative inefficiencies (which they plan to divert to "strengthen mission critical activities," according to the department's budget overview). The CDC requested $11.3 billion for 2012, and said that it includes some $100 million trimmed from administrative costs. (The CDC is part of the Department of Health and Human services, which also runs Medicare and Medicaid, as well as the Food and Drug Administration, the National Institutes of Health and other wellness-related programs; it requested $892 billion for its 2012 budget.)
Given the greatly different natures of the two fields—security and preventive health—in how they report data and their goals, it is difficult to devise a measure of their comparative efficacy. By many counts, preventive health funds are cited as paying off some five times in saved medical costs per every dollar invested, whereas, a similar savings multiplier is not advanced regarding security funds. Likewise, it is also challenging to estimate the dollars per life saved for the various approaches to security and preventive health.
For one pair of researchers, however, the algebra is actually quite clear. [b]For the more than $1 trillion the U.S. has spent on domestic security in the past decade to be justified in terms of lives saved, counterterrorism efforts would need to "have successfully deterred, derailed, disrupted, or protected against attacks that would otherwise have resulted in the deaths of more than 3,000 people in the country every year, equivalent to experiencing attacks as devastating as those on 9/11 at least once a year or 18 Oklahoma City bombings every year,"[/b] the researchers wrote in the August issue of Homeland Security Affairs.
[b]"Even if all of the terrorist plots exposed since 9/11 in the United States had been successfully carried out, their likely consequences would have been much lower,"[/b] John Mueller, chair of National Security Studies at Ohio State University, and Mark Stewart, director of the Center for Infrastructure Performance and Reliability at The University of Newcastle in Australia, noted in their analysis. Although much security work is secretive, thus some thwarted attacks might remain undisclosed, based on public information, the "enhanced expenditures have been excessive…[even though] there are emotional and political pressures on the terrorism issue," they concluded.
The relative levels of security versus health spending on preventable deaths might however, make sense from a psychological perspective. Researchers who study risk perception have found that people tend to assess risk to themselves differently than they do risks to the broader population—even when they know the hard, relative numbers. "Riskiness is based on perception rather fact," Clinton Jenkin, a researcher at the University of New Hampshire, wrote in a 2006 paper published in Homeland Security Affairs.
So although the money spent on different prevention methods might not map out onto the available data, it might show more where our own—culture-driven or innate—fears lie. A lifetime of exposure to unhealthy foods or low levels of exercise has perhaps dulled the dread of a losing battle with heart disease (the leading cause of death in the U.S.), but lingering anxieties about a one-in-a-million-type terrorist attack keep funds—and, as no small consolation, jobs—flowing more freely to domestic security. And who is to say that that extra $1 million for domestic security is not going to supply the extra eyes—or canine nose—that detects the next nefarious plot? The research has already shown what that money would do in a preventive health setting, so perhaps the unknown in the terrorist equation has fueled a fire of uncertainty that keeps those funds flowing.
[QUOTE=bitonti;4132424]read the article it doesn't predict what would have happened, it offers a cost/benefit analysis. Fear-driven spending, what we are spending vs what we are gaining.
a man dies from a terror attack, a different man dies from a stroke, it's still 1 death. it's about cost of prevention, either way.[/QUOTE]
National Defense is a constitutional requirement of our Govt.
Health care is not. Health care is a personal responsabillity.
If I were a betting man, I'd bet we have 100% state-based universal (socialist) Health Care, as a legislated new "human right", in one form or another, for anyone within the US (legal or not) within ~30-50 years or so.
another article from that liberal rag bloomberg businessweek
Opening Remarks September 07, 2011, 11:19 PM EDT
It’s Time to Rethink Counterterrorism Spending
After Sept. 11, no expenditure seemed too great. With a constricted economy and a declining threat, priorities need reexamining
By Romesh Ratnesar
Judged solely on outcomes, the decade-long war on terrorism has been a rousing success. Al Qaeda has been chased out of Afghanistan and Iraq. Its leader and most of his lieutenants are either captured or dead. The organization is on the brink of “strategic defeat,” according to both the U.S. Defense Secretary and the director of the CIA. Across the Middle East, support for jihadist violence has plummeted. Since Sept. 11, 2001, al Qaeda has not mounted one successful strike on American territory—and has failed even to pull off an attack against U.S. targets abroad comparable to the African embassy bombings in 1998 or the attack on the USS Cole in 2000. Brian Michael Jenkins, a terrorism expert at the RAND Corp., writes that the 10 years since Sept. 11 have been “the longest period without a major terrorist attack on the United States since the 1960s.”
That success, however, has not come cheaply. The conflict in Afghanistan is now the longest military engagement in American history. More than 6,000 service members have been killed in Iraq and Afghanistan and upwards of 40,000 seriously wounded. The Congressional Research Service estimates the price tag of the two wars to be at least $1.3 trillion and counting, not including the medical and disability costs associated with treating war veterans, the hit to the global economy caused by the 10-year spike in oil prices, or the rise in military, intelligence, and homeland security spending. Due in part to these second-order, security-related costs, the federal budget has gone from an annual surplus of $128 billion in 2001 to a deficit of more than $1 trillion. The national debt has nearly doubled in the same period, with the amount owed by the U.S. to China growing more than tenfold. And U.S. economic growth in the decade since Sept. 11 has been the slowest since the 1930s.
So was it worth it? Has the money spent by the U.S. to protect itself from terrorism been a sound investment? If the benchmark is the absence of another attack on the American homeland, then the answer is indisputably yes. For the first few years after Sept. 11, there was political near-unanimity that this was all that mattered. In 2005, after the bombings of the London subway system, President Bush sought to reassure Americans by declaring that “we’re spending unprecedented resources to protect our nation.” Any expenditure in the name of fighting terrorism was justified.
Six years later, though, it’s clear this approach is no longer sustainable. Even if the U.S. is a safer nation than it was on Sept. 11, it’s a stretch to say that it’s a stronger one. And in retrospect, the threat posed by terrorism may have been significantly less daunting than Western publics and policymakers imagined it to be.
Sept. 11 was a shock to the U.S. economy. The chaos in Lower Manhattan forced the New York Stock Exchange (NYX) to shut down for six days; when the markets reopened on Sept. 17, the Dow plunged 7 percent. The airline industry required a $10 billion bailout from the federal government. Factor in property damage, insurance payouts, productivity slowdowns, and shaken consumer confidence, and the estimates of what the attacks cost the U.S. economy range somewhere between $100 billion and $500 billion.
Even so, the financial impact of Sept. 11 was modest. The stock market quickly recovered all of the value lost on Sept. 17. Unemployment rose through the beginning of 2002, but within a year, the jobless rate was down to pre-Sept. 11 levels. In his book The Longest War, Peter L. Bergen writes that “while the costs to the U.S. economy of the Sept. 11 attacks were indeed high, [they] could be absorbed in an economy with an annual output of $10 trillion, costing America around 5 percent of her 2001 gross domestic product.”
From an economic point of view, Sept. 11 was far less consequential than the country’s reaction to it. After the destruction of the World Trade Center, the public was gripped with fears of a second attack, and the Bush Administration believed that another strike “would have been catastrophic to the economy,” says Joseph W. Hagin, then Deputy White House Chief of Staff. “People forget what it was like. … Consumer spending had declined dramatically, especially in major cities. People were afraid to get on airlines. It was pretty desperate.” In an attempt to boost confidence, Bush implored the public to go shopping, and had dinner at Morton’s The Steakhouse (MRT) in downtown Washington to “signal to the country that it was O.K. to get back out there and spend money,” Hagin says.
Politicians and pundits frequently said that al Qaeda posed an “existential threat” to the U.S. But governments can’t defend against existential threats—they can only overspend against them. And national intelligence was very late in understanding al Qaeda’s true capabilities. At its peak, al Qaeda’s ranks of hardened operatives numbered in the low hundreds—and that was before the U.S. and its allies launched a global military campaign to dismantle the network. “We made some bad assumptions right after Sept. 11 that shaped how we approached the war on terror,” says Brian Fishman, a counterterrorism research fellow at the New America Foundation. “We thought al Qaeda would run over the Middle East—they were going to take over governments and control armies. In hindsight, it’s clear that was never going to be the case. Al Qaeda was not as good as we gave them credit for.”
Yet for a decade, the government’s approach to counterterrorism has been premised in part on the idea that not only would al Qaeda attack inside the U.S. again, but its next strike would be even bigger—possibly involving unconventional weapons or even a nuclear bomb. Washington has appropriated tens of billions trying to protect against every conceivable kind of attack, no matter the scale or likelihood. To cite one example, the U.S. spends $1 billion a year to defend against domestic attacks involving improvised-explosive devices, the makeshift bombs favored by insurgents in Afghanistan. “In hindsight, the idea that post-Sept. 11 terrorism was different from pre-9/11 terrorism was wrong,” says Brian A. Jackson, a senior physical scientist at RAND. “If you honestly believed the followup to 9/11 would be a nuclear weapon, then for intellectual consistency you had to say, ‘We’ve got to prevent everything.’ We pushed for perfection, and in counterterrorism, that runs up the tab pretty fast.”
Nowhere has that profligacy been more evident than in the area of homeland security. “Things done in haste are not done particularly well,” says Jackson. As Daveed Gartenstein-Ross writes in his new book, Bin Laden’s Legacy, the creation of a homeland security apparatus has been marked by waste, bureaucracy, and cost overruns. Gartenstein-Ross cites the Transportation Security Agency’s rush to hire 60,000 airport screeners after Sept. 11, which was originally budgeted at $104 million; in the end it cost the government $867 million. The homeland security budget has also proved to be a pork barrel bonanza: In perhaps the most egregious example, the Kentucky Charitable Gaming Dept. received $36,000 to prevent terrorists from raising money at bingo halls. “If you look at the past decade and what it’s cost us, I’d say the rate of return on investment has been poor,” Gartenstein-Ross says.
A certain degree of overreaction was probably inevitable. “We had to respond the way we did because the American psyche demanded it,” says Rick “Ozzie” Nelson, a former official at the National Counterterrorism Center and a senior fellow at the Center for Strategic and International Studies. “We overreacted in some respects, but we also have a tendency to lose sight of how effective we’ve been.” Because homeland security spending involved a good deal of one-time expenditures, from securing cockpit doors to staffing new federal agencies, some costs can be amortized.
The post-Sept. 11 era has also produced improvements in intelligence, information sharing, and military preparation that will yield future dividends, Nelson says. “Our national security bureaucracies are better coordinated and operating more closely than they ever have in the history of our government,” he says. “The benefits will go beyond just fighting terrorism.”
Determining the costs and benefits of the war on terrorism ultimately will depend less on what has transpired over the last decade than what happens over the next. Wasteful security spending, exaggerations of al Qaeda’s strength, hubristic attempts to remake the Middle East—the excesses of America’s response to Sept. 11 can be excused, at least in part, by its desire to avert another trauma. But future generations will not be so charitable if we fail to learn from our mistakes, continue to put terrorism above other national priorities, and insist that every attack must be prevented, no matter the cost. “Al Qaeda is on its knees, and we’ve disrupted a lot of its activities,” Nelson says. “But now that we’ve curtailed that threat, we do need to adjust our resources in a way that is more appropriately aligned to the risks we are actually facing.” Ten years on, the wisest way for Americans to deal with the threat of another Sept. 11 is to stop obsessing about it. Otherwise, the terrorists will have won.
Ratnesar is deputy editor of Bloomberg Businessweek.